Adipose tissue quantification and primary graft dysfunction after lung transplantation: The Lung Transplant Body Composition study

Michaela R. Anderson; Jayaram K. Udupa; Ethan Edwin; Joshua M. Diamond; Jonathan P. Singer; Jasleen Kukreja; Steven R. Hays; John R. Greenland; Anthony Ferrante; Matthew Lippel; Tatiana Blue; Amika McBurnie; Michelle Oyster; Laurel Kalman; Melanie Rushefski; Caiyun Wu; Gargi Pednekar; Wen Liu; Selim Arcasoy; Joshua Sonett; Frank D'Ovidio; Matthew Bacchetta; John D. Newell; Drew Torigian; Edward Cantu; Donna L. Farber; Jon T. Giles; Yubing Tong; Scott Palmer; Lorraine B. Ware; Wayne W. Hancock; Jason D. Christie; David J. Lederer

doi:10.1016/j.healun.2019.08.013

Adipose tissue quantification and primary graft dysfunction after lung transplantation: The Lung Transplant Body Composition study

Michaela R. Anderson
, Jayaram K. Udupa
, Ethan Edwin
, Joshua M. Diamond
, Jonathan P. Singer
, Jasleen Kukreja
, Steven R. Hays
, John R. Greenland
, Anthony Ferrante
, Matthew Lippel
, Tatiana Blue
, Amika McBurnie
, Michelle Oyster
, Laurel Kalman
, Melanie Rushefski
, Caiyun Wu
, Gargi Pednekar
, Wen Liu
, Selim Arcasoy
, Joshua Sonett

Frank D'Ovidio, Matthew Bacchetta, John D. Newell, Drew Torigian, Edward Cantu, Donna L. Farber, Jon T. Giles, Yubing Tong, Scott Palmer, Lorraine B. Ware, Wayne W. Hancock, Jason D. Christie, David J. Lederer

Surgery

Research output: Contribution to journal › Article › peer-review

42 Scopus citations

Abstract

BACKGROUND: Obesity is associated with an increased risk of primary graft dysfunction (PGD) after lung transplantation. The contribution of specific adipose tissue depots is unknown. METHODS: We performed a prospective cohort study of adult lung transplant recipients at 4 U.S. transplant centers. We measured cross-sectional areas of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) on chest and abdominal computed tomography (CT) scans and indexed each measurement to height.² We used logistic regression to examine the associations of adipose indices and adipose classes with grade 3 PGD at 48 or 72 hours, and Cox proportional hazards models to examine survival. We used latent class analyses to identify the patterns of adipose distribution. We examined the associations of adipose indices with plasma biomarkers of obesity and PGD. RESULTS: A total of 262 and 117 subjects had available chest CT scans and underwent protocol abdominal CT scans, respectively. In the adjusted models, a greater abdominal SAT index was associated with an increased risk of PGD (odds ratio 1.9, 95% CI 1.02–3.4, p = 0.04) but not with survival time. VAT indices were not associated with PGD risk or survival time. A greater abdominal SAT index correlated with greater pre- and post-transplant leptin (r = 0.61, p < 0.001, and r = 0.44, p < 0.001), pre-transplant IL-1RA (r = 0.25, p = 0.04), and post-transplant ICAM-1 (r = 0.25, p = 0.04). We identified 3 latent patterns of adiposity. The class defined by high thoracic and abdominal SAT had the greatest risk of PGD. CONCLUSIONS: Subcutaneous, but not visceral, adiposity is associated with an increased risk of PGD after lung transplantation.

Original language	English
Pages (from-to)	1246-1256
Number of pages	11
Journal	Journal of Heart and Lung Transplantation
Volume	38
Issue number	12
DOIs	https://doi.org/10.1016/j.healun.2019.08.013
State	Published - Dec 2019

Bibliographical note

Publisher Copyright:
© 2019 International Society for Heart and Lung Transplantation

Funding

The authors have no conflicts of interest to disclose. This study was supported by National Institutes of Health / National Heart, Lung, and Blood Institute grants R01 HL114626 , R01 HL087115 , K24 HL115354 , K24 HL 131937 , K23 HL121406 , K23 HL111115 , T32 HL105323 , K23 HL 116656 , R03 HL135227 , R01 DK066525 , T32 DK07328 , R01 HL134851 , and VA ORD IK2 CX001034 , and by Robert Woods Johnson AMFDP 70640 and the Stony-Wold Herbert Foundation. We gratefully acknowledge our research coordinators for their work on patient recruitment, data acquisition, and specimen storage, and our patients for their participation in the study. We additionally acknowledge the methodological input of A. Russell Localio, PhD. The authors have no conflicts of interest to disclose. This study was supported by National Institutes of Health/ National Heart, Lung, and Blood Institute grants R01 HL114626, R01 HL087115, K24 HL115354, K24 HL 131937, K23 HL121406, K23 HL111115, T32 HL105323, K23 HL 116656, R03 HL135227, R01 DK066525, T32 DK07328, R01 HL134851, and VA ORD IK2 CX001034, and by Robert Woods Johnson AMFDP 70640 and the Stony-Wold Herbert Foundation.

Funders	Funder number
Stony-Wold Herbert Foundation
Research Grants Council, University Grants Committee
National Heart, Lung, and Blood Institute (NHLBI)	K23HL116656, 70640, R03HL135227, K23HL121406, VA ORD IK2 CX001034, T32HL105323, K24HL115354, R01HL087115, R01HL134851, K23HL111115, R01HL114626, K24HL131937
National Institutes of Health (NIH)	L30HL143645
U.S. Department of Veterans Affairs	IK2CX001034
National Institute of Diabetes and Digestive and Kidney Diseases	R01DK066525, T32DK007328

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

adipose tissue
inflammation
lung transplantation
obesity
primary graft dysfunction

ASJC Scopus subject areas

Surgery
Pulmonary and Respiratory Medicine
Cardiology and Cardiovascular Medicine
Transplantation

Access to Document

10.1016/j.healun.2019.08.013

Cite this

Anderson, M. R., Udupa, J. K., Edwin, E., Diamond, J. M., Singer, J. P., Kukreja, J., Hays, S. R., Greenland, J. R., Ferrante, A., Lippel, M., Blue, T., McBurnie, A., Oyster, M., Kalman, L., Rushefski, M., Wu, C., Pednekar, G., Liu, W., Arcasoy, S., ... Lederer, D. J. (2019). Adipose tissue quantification and primary graft dysfunction after lung transplantation: The Lung Transplant Body Composition study. Journal of Heart and Lung Transplantation, 38(12), 1246-1256. https://doi.org/10.1016/j.healun.2019.08.013

@article{7e82ca364901404084fa0cf861ea13b9,

title = "Adipose tissue quantification and primary graft dysfunction after lung transplantation: The Lung Transplant Body Composition study",

abstract = "BACKGROUND: Obesity is associated with an increased risk of primary graft dysfunction (PGD) after lung transplantation. The contribution of specific adipose tissue depots is unknown. METHODS: We performed a prospective cohort study of adult lung transplant recipients at 4 U.S. transplant centers. We measured cross-sectional areas of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) on chest and abdominal computed tomography (CT) scans and indexed each measurement to height.2 We used logistic regression to examine the associations of adipose indices and adipose classes with grade 3 PGD at 48 or 72 hours, and Cox proportional hazards models to examine survival. We used latent class analyses to identify the patterns of adipose distribution. We examined the associations of adipose indices with plasma biomarkers of obesity and PGD. RESULTS: A total of 262 and 117 subjects had available chest CT scans and underwent protocol abdominal CT scans, respectively. In the adjusted models, a greater abdominal SAT index was associated with an increased risk of PGD (odds ratio 1.9, 95\% CI 1.02{\textendash}3.4, p = 0.04) but not with survival time. VAT indices were not associated with PGD risk or survival time. A greater abdominal SAT index correlated with greater pre- and post-transplant leptin (r = 0.61, p < 0.001, and r = 0.44, p < 0.001), pre-transplant IL-1RA (r = 0.25, p = 0.04), and post-transplant ICAM-1 (r = 0.25, p = 0.04). We identified 3 latent patterns of adiposity. The class defined by high thoracic and abdominal SAT had the greatest risk of PGD. CONCLUSIONS: Subcutaneous, but not visceral, adiposity is associated with an increased risk of PGD after lung transplantation.",

keywords = "adipose tissue, inflammation, lung transplantation, obesity, primary graft dysfunction",

author = "Anderson, \{Michaela R.\} and Udupa, \{Jayaram K.\} and Ethan Edwin and Diamond, \{Joshua M.\} and Singer, \{Jonathan P.\} and Jasleen Kukreja and Hays, \{Steven R.\} and Greenland, \{John R.\} and Anthony Ferrante and Matthew Lippel and Tatiana Blue and Amika McBurnie and Michelle Oyster and Laurel Kalman and Melanie Rushefski and Caiyun Wu and Gargi Pednekar and Wen Liu and Selim Arcasoy and Joshua Sonett and Frank D'Ovidio and Matthew Bacchetta and Newell, \{John D.\} and Drew Torigian and Edward Cantu and Farber, \{Donna L.\} and Giles, \{Jon T.\} and Yubing Tong and Scott Palmer and Ware, \{Lorraine B.\} and Hancock, \{Wayne W.\} and Christie, \{Jason D.\} and Lederer, \{David J.\}",

note = "Publisher Copyright: {\textcopyright} 2019 International Society for Heart and Lung Transplantation",

year = "2019",

month = dec,

doi = "10.1016/j.healun.2019.08.013",

language = "English",

volume = "38",

pages = "1246--1256",

number = "12",

}

Anderson, MR, Udupa, JK, Edwin, E, Diamond, JM, Singer, JP, Kukreja, J, Hays, SR, Greenland, JR, Ferrante, A, Lippel, M, Blue, T, McBurnie, A, Oyster, M, Kalman, L, Rushefski, M, Wu, C, Pednekar, G, Liu, W, Arcasoy, S, Sonett, J, D'Ovidio, F, Bacchetta, M, Newell, JD, Torigian, D, Cantu, E, Farber, DL, Giles, JT, Tong, Y, Palmer, S, Ware, LB, Hancock, WW, Christie, JD & Lederer, DJ 2019, 'Adipose tissue quantification and primary graft dysfunction after lung transplantation: The Lung Transplant Body Composition study', Journal of Heart and Lung Transplantation, vol. 38, no. 12, pp. 1246-1256. https://doi.org/10.1016/j.healun.2019.08.013

TY - JOUR

T1 - Adipose tissue quantification and primary graft dysfunction after lung transplantation

T2 - The Lung Transplant Body Composition study

AU - Anderson, Michaela R.

AU - Udupa, Jayaram K.

AU - Edwin, Ethan

AU - Diamond, Joshua M.

AU - Singer, Jonathan P.

AU - Kukreja, Jasleen

AU - Hays, Steven R.

AU - Greenland, John R.

AU - Ferrante, Anthony

AU - Lippel, Matthew

AU - Blue, Tatiana

AU - McBurnie, Amika

AU - Oyster, Michelle

AU - Kalman, Laurel

AU - Rushefski, Melanie

AU - Wu, Caiyun

AU - Pednekar, Gargi

AU - Liu, Wen

AU - Arcasoy, Selim

AU - Sonett, Joshua

AU - D'Ovidio, Frank

AU - Bacchetta, Matthew

AU - Newell, John D.

AU - Torigian, Drew

AU - Cantu, Edward

AU - Farber, Donna L.

AU - Giles, Jon T.

AU - Tong, Yubing

AU - Palmer, Scott

AU - Ware, Lorraine B.

AU - Hancock, Wayne W.

AU - Christie, Jason D.

AU - Lederer, David J.

PY - 2019/12

Y1 - 2019/12

N2 - BACKGROUND: Obesity is associated with an increased risk of primary graft dysfunction (PGD) after lung transplantation. The contribution of specific adipose tissue depots is unknown. METHODS: We performed a prospective cohort study of adult lung transplant recipients at 4 U.S. transplant centers. We measured cross-sectional areas of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) on chest and abdominal computed tomography (CT) scans and indexed each measurement to height.2 We used logistic regression to examine the associations of adipose indices and adipose classes with grade 3 PGD at 48 or 72 hours, and Cox proportional hazards models to examine survival. We used latent class analyses to identify the patterns of adipose distribution. We examined the associations of adipose indices with plasma biomarkers of obesity and PGD. RESULTS: A total of 262 and 117 subjects had available chest CT scans and underwent protocol abdominal CT scans, respectively. In the adjusted models, a greater abdominal SAT index was associated with an increased risk of PGD (odds ratio 1.9, 95% CI 1.02–3.4, p = 0.04) but not with survival time. VAT indices were not associated with PGD risk or survival time. A greater abdominal SAT index correlated with greater pre- and post-transplant leptin (r = 0.61, p < 0.001, and r = 0.44, p < 0.001), pre-transplant IL-1RA (r = 0.25, p = 0.04), and post-transplant ICAM-1 (r = 0.25, p = 0.04). We identified 3 latent patterns of adiposity. The class defined by high thoracic and abdominal SAT had the greatest risk of PGD. CONCLUSIONS: Subcutaneous, but not visceral, adiposity is associated with an increased risk of PGD after lung transplantation.

AB - BACKGROUND: Obesity is associated with an increased risk of primary graft dysfunction (PGD) after lung transplantation. The contribution of specific adipose tissue depots is unknown. METHODS: We performed a prospective cohort study of adult lung transplant recipients at 4 U.S. transplant centers. We measured cross-sectional areas of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) on chest and abdominal computed tomography (CT) scans and indexed each measurement to height.2 We used logistic regression to examine the associations of adipose indices and adipose classes with grade 3 PGD at 48 or 72 hours, and Cox proportional hazards models to examine survival. We used latent class analyses to identify the patterns of adipose distribution. We examined the associations of adipose indices with plasma biomarkers of obesity and PGD. RESULTS: A total of 262 and 117 subjects had available chest CT scans and underwent protocol abdominal CT scans, respectively. In the adjusted models, a greater abdominal SAT index was associated with an increased risk of PGD (odds ratio 1.9, 95% CI 1.02–3.4, p = 0.04) but not with survival time. VAT indices were not associated with PGD risk or survival time. A greater abdominal SAT index correlated with greater pre- and post-transplant leptin (r = 0.61, p < 0.001, and r = 0.44, p < 0.001), pre-transplant IL-1RA (r = 0.25, p = 0.04), and post-transplant ICAM-1 (r = 0.25, p = 0.04). We identified 3 latent patterns of adiposity. The class defined by high thoracic and abdominal SAT had the greatest risk of PGD. CONCLUSIONS: Subcutaneous, but not visceral, adiposity is associated with an increased risk of PGD after lung transplantation.

KW - adipose tissue

KW - inflammation

KW - lung transplantation

KW - obesity

KW - primary graft dysfunction

UR - https://www.scopus.com/pages/publications/85071379533

UR - https://www.scopus.com/pages/publications/85071379533#tab=citedBy

U2 - 10.1016/j.healun.2019.08.013

DO - 10.1016/j.healun.2019.08.013

M3 - Article

C2 - 31474492

AN - SCOPUS:85071379533

SN - 1053-2498

VL - 38

SP - 1246

EP - 1256

JO - Journal of Heart and Lung Transplantation

JF - Journal of Heart and Lung Transplantation

IS - 12

ER -

Adipose tissue quantification and primary graft dysfunction after lung transplantation: The Lung Transplant Body Composition study

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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